Bird Flu Vaccine Protects Half The People Who Take It

According to researchers, a new experimental bird flu (avian flu) vaccine protects 54% of people who get two shots at a very high dose (90 micrograms). This dose is twelve times higher than that needed for protection from normal human flu.

You can read about this research in the New England Journal of Medicine (NEJM).

451 volunteers took part in this trial.

70% of those who got the shot had some kind of immune response, however, it was not possible to know how protective this response might be, said the researchers.

According to Dr. J Treanor, University of Rochester, New York, even at such a high dose, the vaccine seems to be completely safe for humans. He also added that as nearly all humans have not been exposed to H5N1 at all, developing an immune response takes time.

Whether or not a third dose may up the immune response of more participants remains to be seen. The scientists say they plan to administer a third dose. They also said that by adding such chemicals as alum or MF59, it may be possible to lower the dose.

As there are now two types of H5N1 virus strains, it is not known whether this vaccine offers protection from both.

The vaccine is made by Sanofi-Aventis and was developed from a H5N1 virus strain obtained in Vietnam two years ago.

For a human to become ill as a result of H5N1 infection, the virus has to make its way deep into the lungs. This is why humans cannot catch bird flu easily and cannot easily transmit it to other humans. An infected person who coughs or sneezes expels hardly any of the viruses (because they are too deep inside the lungs). If the virus mutates, so that it can easily be transmitted from human-to-human, it will need to attack the upper parts of the lungs. If it manages to do this, it will be much easier to treat.

Written by: Christian Nordqvist
Editor: Medical News Today

Prostate Treatment Decisions Based On Perception More Than Fact

Men with prostate cancer generally make treatment decisions based on differences in the information they receive rather than their own preferences, according to a new review. Published in the May 1, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society, the review of studies in prostate cancer decision making suggests that a lack of medical evidence and consistent, comprehensive messages about therapeutic options compel men to turn to a wide variety of popular and biased sources, which influence their decision. This approach often results in treatments that do not generally reflect patients' goals.

Despite new treatment options for prostate cancer, there is little evidence-based consensus in the oncology community about the most efficacious treatment. Newly diagnosed patients must still balance existing information about risks and benefits of available therapies with their own treatment objectives. Studies have shown that prostate cancer treatment varies not only among men in general but also by race and ethnicity, suggesting that the guidance patients receive is variable and confusing, and plays a part in their decision-making. Steven B. Zeliadt, Ph.D., M.P.H., of the Fred Hutchinson Cancer Center in Seattle and colleagues synthesized data from other studies to examine how and why men with prostate cancer make treatment decisions.

The review of current literature shows that cancer eradication or control was the foremost objective of treatment for men. Minimizing side effects ultimately played a minor role in decision making. However, studies report a gap between patient treatment objectives and the evidence supporting the efficacy of the treatment chosen. Men's concerns about controlling "the cancer" correlated directly with the aggressiveness of the treatment they chose, regardless of actual disease severity. Yet, in choosing treatment, patients did not consistently rely on scientific evidence of a therapy's efficacy to control disease or prolong life. As few as one in four patients in one study relied on evidence of a treatment efficacy for their decision.

Physicians and family, as well as race and culture may affect patients' decisions, but the degree of their respective influence varies in the literature and is often poorly measured, according to the review. Notably, physicians tended to present therapies in ways that were both confusing and dismissive of patient concerns about risks. This either biased patients' decisions or turned patients to other sources of information.

Finally, studies fail to show how and if patients actually critically analyze the quality of information they receive. It is very likely, the authors add, that patients "have significant limitations in their ability to identify biased information, as well as their ability to weigh complex information about the outcomes that are important to them."

"The perceptions of treatment efficacy related to cancer control far outweigh available supporting evidence, and most patients appear to select a prostate cancer treatment primarily based on its perceived ability to control the tumor," conclude the authors.

###

Article: "Why Do Men Choose One Treatment Over Another? A Review of Patient Decision Making for Localized Prostate Cancer," Steven B. Zeliadt, Scott D. Ramsey, David F. Penson, Ingrid J. Hall, Donatus U. Ekwueme, Leonard Stroud, Judith W. Lee, CANCER; Published Online: March 27, 2006 (DOI: 10.1002/cncr.21822); Print Issue Date: May 1, 2006.

Contact: Amy Molnar
amolnar@wiley.com
John Wiley & Sons, Inc.

Hope For Depression Sufferers: Became Symptom Free After Changing To, Or Adding A Second Antidepressant

If a first antidepressant medication doesn't work, try a different one, UT Southwestern Medical Center researchers report.

New research shows that one in three to four people who do not achieve a full remission of symptoms from an initial antidepressant became symptom-free after changing to or adding a second antidepressant. Phase two results of the four-phase study on treatments for depression - the largest of its kind - appear online in two companion articles in today's New England Journal of Medicine.

"The message to the patient is: 'Hang in there. If the first treatment does not relieve your symptoms, consider changing or adding another medication. Follow instructions from your doctor, and don't give up,' " said Dr. A. John Rush, vice chairman of clinical sciences and professor of psychiatry at UT Southwestern. He is principal investigator of the study and lead author of one of the articles. "For a depressed individual, it may not matter so much what drug is being prescribed, but that the person moves forward and keeps trying."

Designed to assess the effectiveness of various treatments for depression in "real-world" settings for people who also have other medical and psychiatric conditions, the $35 million, six-year study - designated STAR'D (Sequenced Treatment Alternatives to Relieve Depression) and funded by the National Institute of Mental Health (NIMH) - involved nearly 3,000 patients at 41 primary-care and psychiatric clinics. Researchers at 14 medical institutions worked together under the direction of UT Southwestern as the national coordinating center.

In phase one of the study, participants were treated with the antidepressant citalopram hydrobromide (Celexa) for up to 14 weeks. A "measurement-based care" approach was used, whereby patients' symptoms and medication side effects were evaluated at each visit based on certain guidelines, with dosages modified as needed.

At the end of phase one, about one-third of the participants were symptom-free. The two-thirds who didn't achieve remission could select from several treatment options - including whether to change medications or continue using citalopram and add a second medication. Of those, 1,429 continued in the study.

The patients who chose to switch medications were randomized into three groups receiving one of three popular antidepressants: bupropion hydrochloride-SR (Wellbutrin-SR), sertraline hydrochloride (Zoloft) or venlafaxine hydrochloride-XR (Effexor-XR). Of those, approximately 25 percent achieved remission of symptoms within 14 weeks, with no significant differences in efficacy, safety or tolerability between the three drugs.

Participants who decided to add a medication were given either bupropion hydrochloride-SR or buspirone hydrochloride, along with citalopram, which they were already taking. Within 14 weeks, 30 percent of these patients became symptom-free, with neither medication combination statistically different in its effectiveness on primary outcomes.

"These results show that augmenting a first antidepressant with a second one may be worthwhile for some patients and might be considered even earlier for some people," said Dr. Madhukar Trivedi, professor of psychiatry at UT Southwestern and lead author of one of the studies.

"If you add together the people who achieved remission in both phase one and phase two of STAR'D, you see that more than 50 percent of participants become symptom-free after one or two treatments," Dr. Trivedi said. "That is exciting. If you compare this to the vast majority of other chronic medical diseases, getting to remission in this large percentage is good news."

Each year, about 19 million American adults - or 9.5 percent of the population - struggle with depression, a recurring and chronic illness. It frequently returns two or more times, each episode usually lasting two years or more. Depression, the fourth-most disabling illness worldwide, cost the United States an estimated $83 billion in the year 2000.

"The bottom line is, 'If you can hang in there for at least two different treatments, you have better than a 50 percent chance of not just getting better, but getting well,' " said Dr. Rush.

"The bad news is that we still have a way to go with the 40 percent of people who've had two different drug treatments and still haven't achieved remission - which means that we need better treatments," he said. "For a person walking into a doctor's office with depression, that could mean that your first treatment may not be your last. But it does suggest that it's worthwhile to keep on trying."

Dr. Trivedi said the study also points to the need for further research to help customize treatments to individual patients. Results of phases three and four of the STAR'D study are expected to be published later this year, he said.

###

Also participating from UT Southwestern in the study were Dr. Diane Warden, assistant professor of psychiatry, Dr. Kathy Shores-Wilson, adjunct assistant professor of psychiatry, and Dr. Melanie M. Biggs, associate professor of family and community medicine and psychiatry. In addition, researchers from the University of Pittsburgh; the New York State Psychiatric Institute and the College of Physicians and Surgeons of Columbia University; Massachusetts General Hospital; the University of Pittsburgh School of Medicine; NIMH; and the STAR*D study team were included.

This news release is available on our World Wide Web home page at http://www.utsouthwestern.edu/home/news/index.html

To automatically receive news releases from UT Southwestern via e-mail, subscribe at http://www.utsouthwestern.edu/receivenews

Contact: Donna Steph Hansard
donna.hansard@utsouthwestern.edu
UT Southwestern Medical Center

Pregnancy Research Leads To Progress On Premature Delivery

The University of Rochester has filed a patent on several ideas to help prevent early labor and the premature delivery of low-birth-weight babies. The discovery is an incremental step in an area of obstetrics that has seen little improvement in 20 years.

Mark Plessinger, Ph.D., assistant professor of Obstetrics and Gynecology at the University of Rochester Medical Center, discovered that certain proteins known as toll-like receptors (TLRs), located in the amniotic membranes of pregnant women, sometimes fuel a harmful inflammatory response. The inflammation, in turn, may cause the fetal membranes to rupture and lead to preterm labor.

The pending University patent protects the development of a chemical test to ascertain the effectiveness of drugs that could be used to treat women at greater risk of preterm delivery. Other claims of the patent protect the idea that once these agents are identified, a drug might be developed to block the TLRs and stop early labor.

Plessinger is showcasing the research this week in Toronto at the annual meeting of the Society for Gynecological Investigation. Although doctors today can treat women in early labor with antibiotics and other drugs designed to slow contractions, studies have demonstrated that this approach is often ineffective.

"I am optimistic that we have landed on a novel idea," Plessinger said, "although it is far from therapeutic intervention."

Premature delivery is when an infant is born before 37 weeks of pregnancy. It occurs in about 12 percent of pregnancies in the United States and is the leading cause of infant death, according to the National Vital Statistics Report for 2004. When premature babies do survive they often face many health problems.

To better understand what brings on preterm labor, Plessinger started by isolating the cells within the amniotic membranes. The membranes are balloon-like, wrapping around the fetus and the amniotic fluid in which the fetus is bathed. The cells within the membranes (both fibroblasts and epithelial) are critical to the chemical process that causes the premature rupture of the fetal membranes. This is known as when a woman's "water breaks," and once that happens it is difficult to stop the ensuing delivery.

Meanwhile, in related investigations, researchers discovered that in nearly 80 percent of the cases of preterm labor, bacteria are present in the amniotic fluid. Plessinger's lab has been focusing on the association between the infectious organisms and the amniotic fibroblasts, zeroing in on E. coli as a potential culprit. (Many premature babies test positive for E. coli.)

Plessinger hypothesizes that when the mother's body tries to fight off the offending bacteria, the TLRs activate and cause inflammation. The inflammatory cells brought in to kill off the infectious microbes may pump naturally occurring hypochlorous acids and enzymes from the body into the fetal membranes, causing them to break apart and rupture.

Plessinger and colleagues Melanie O'Bara and Dongdong Guo, discovered the existence of the toll-like receptors and their role in fueling an inflammatory response after they had isolated amniotic cells from women who experienced normal, full-term delivery and cells from women who went into early labor.

"The big question is: What is it about the inflammatory process that impacts the fetal membranes and starts the entire chain of events that leads to early labor?" Plessinger said. "We are on a path to discovering that answer, and we hope it will lead us to the development of a new class of drugs that can shut down the process of premature delivery."

###

The National Institutes of Health has been funding the research.

Contact: Leslie Orr
Leslie_Orr@urmc.rochester.edu
University of Rochester Medical Center

No Evidence That Fish Oils Are Good For The Heart

For decades we have all been convinced that fish oils, specifically, omega-3 fats, are good for us - they are supposed to protect us from heart disease, cancer and cognitive decline. A new comprehensive study seems to indicate that as far as the heart disease and cancer protection is concerned, this may all be a myth.

According to a review in the British Medical Journal (BMJ) which looked at 89 previous studies, there is no evidence that fish oils protect us from heart disease, strokes or cancer.

A large trial in 2003 looked at over 3,000 men with stable angina. Those who were given high quantities of oily fish actually increased their risk of heart attack. The researchers, in fact, recorded a higher number of deaths among those men who consumed large amounts of oily fish. The scientists concluded that there is no evidence about the benefits of consuming fish oils for people with cardiovascular disease.

This trial was carried out by researchers at the University of East Anglia, Norwich, UK. Team leader, Lee Hooper, said "UK guidelines encourage the general public to eat more oily fish, and higher amounts are advised after myocardial infarction. This advice should continue at present, but the evidence should be reviewed regularly. It is probably not appropriate to recommend a high intake of omega-3 fats for people who have angina but have not had a myocardial infarction."

(Myocardial Infarction = Heart Attack)

Several experts have written to Medical News Today stressing that people should not change their consumption of omega-3 fats or oily fish. The evidence so far is that people with existing heart conditions may experience higher risks - but more studies are needed.

Basically, the position of the scientific community now, after this report, is that there is no clear evidence either way for anyone (with or without existing heart conditions).

Some have suggested that the variations in study results may have more to do with mercury levels in oily fish than their benefits (or not).

Written by: Christian Nordqvist
Editor: Medical News Today

Fall In Applications For New Medicines, EMEA - Increases In Years To Come

The European Medicines Agency Management Board adopted the Agency's annual report for 2005 at its 50th meeting, on 9 March 2006. The report shows that fewer initial marketing authorisation applications for new medicines for human use were received in 2005 than expected.

Whereas 52 were forecast, 43 were actually received (2004: 51, 2003: 39). The number of applications for authorisation of designated orphan medicines, however, remained strong, with 15 applications received.

Forecast figures indicate an upward trend for 2006 and 2007, with 62 and 79 initial marketing authorisation applications expected respectively, including applications for similar biological and generic medicinal products.

The 2005 annual report also shows that there was an increase in the number of applications for orphan designation, at 118 (2004: 108, 2003: 87), and that requests for scientific advice and protocol assistance for new human medicines were up by almost 60% compared to levels in 2004 (2005: 194, 2004: 122).

A similar increase in scientific advice requests was seen for veterinary medicines, with twice as many received in 2005 as in 2004 (2005: 10, 2004: 5). The number of marketing authorisation applications for veterinary medicines was in line with the forecast (2005: 11; 2004: 8). A positive trend is forecast in the coming years for veterinary medicines, with 14 and 16 applications expected for 2006 and 2007 respectively.

Draft work programme and budget for 2007

The Management Board also adopted the draft work programme for 2007, as well as a preliminary draft budget for 2007 that, once approved by the European Parliament and Council later in 2006, would see the Agency's total budget rise to EUR 144.1 million (2006: EUR 123.6 million, 2005: EUR 111.8 million). This increase reflects the forecast increase in number of applications and new workload in 2007, with total fee revenue expected to reach EUR 91.8 million (2006: EUR 83.6 million, 2005: EUR 77.5 million). The Board approved requests for 17 new staff members in 2007, which would take the maximum staff complement to 441.

EMEA priorities for 2007, as outlined in the draft work programme, follow the Agency's long-term strategy and build on priorities set in previous years. Priorities for 2007 include:

-- Improving the safety of medicines for human and veterinary use.

-- Establishing the new Paediatric Committee, which will provide opinions on Paediatric Investigation Plans, plus coordinating a paediatric research network and providing information on paediatric clinical trials, as part of the Agency's implementation of the upcoming legislation on medicines for children.

-- Contributing towards the stimulation of research and development in Europe to allow for better access to new and innovative medicines.

-- Increasing openness and transparency of the Agency's operations, and providing high-quality and timely information on medicines to patients and healthcare professionals.

-- Increasing international cooperation and interaction with non-EU countries.

The annual report for 2005 will be published shortly on the EMEA website. The next meeting of the Management Board is on 8 June 2006.

European Medicines Agency

Exercise Reduces Menopausal Symptoms And Improves Quality Of Life

Regular exercise can reduce severe symptoms in menopausal women and improve their quality of life, according to a study in the latest Journal of Advanced Nursing.

Researchers from the University of Granada in Spain found that the number of women suffering severe symptoms fell by a quarter after they took part in a 12-month supervised exercise programme, while problems increased among women who didn't exercise.

Fifty per cent of the 24-strong exercise group had severe symptoms at the start of the programme compared with 37 per cent at the end. 58 per cent of the 24 women in the non-exercise group reported problems at the start of the study and this rose to 67 per cent over the same period.

“The group that improved took part in three hours of fully supervised exercise a week for 12 months” explains lead researcher Professor Carmen VillaverdeGutierrez.

“This comprised cardio respiratory, stretching, musclestrengthening and relaxation exercises.

“As well as monitoring severe symptoms, we also looked at the women's quality of life and found that the average scores for the exercise group improved while those for the control group decreased.”

For example, at the start of the study the exercise group averaged 2.80 on a specialist social well-being scale and the control group average 2.86. By the end of the study the exercise group has risen to 2.91 but the control group had fallen considerably to 2.16.

The exercise group also increased their average scores on scales measuring physical and psychological functioning and positive state of mind, with the control group showing reduced averages.

Women taking part in the study were recruited from a health centre near Grenada following a thorough health assessment by both a doctor and nurse. The 48 women, who had an average age of just over 60, were randomly assigned to the exercise and control groups.

73 per cent had started their menopause naturally, rather than after surgery, and 60 per cent had been going through it for more than 10 years. None of them exercised and 76 per cent were classified as overweight or obese according to their Body Mass Index.

Before each twice-weekly session the exercise group were assessed by the physiotherapist leading the programme and a nurse. The women's mobility, flexibility, balance, co-ordination were checked, together with elements such as cardio respiratory strength.

The control group did not exercise but they did attend monthly meetings where their blood pressure and general health was checked to ensure that no medical issues had developed that could affect the final results.

All the women completed the study and the average attendance at meetings and exercise sessions was 90 per cent.

“Joining the regular exercise programme improved the women's health and also gave them the chance to join a sociable group activity and reduce feelings of loneliness” says Professor Villaverde-Gutierrez.

“Our findings suggest that regular exercise programmes can help to alleviate some of the physical symptoms associated with the menopause and improve women's health and quality of life.

“We would like to see exercise programmes offered as an integral part of primary healthcare for menopausal women. At the very least, women going through the menopause should be encouraged to join a local exercise group suitable for their age and health so that they can share the benefits experienced by the women in our study.”

• Quality of life of rural menopausal women in response to a customized exercise programme. Villaverde-Gutierrez et al, University of Grenada, Spain. Journal of Advanced Nursing. Volume 54.1, pages 11-19. (March 2006).

• Journal of Advanced Nursing, which is celebrating its 30th anniversary in 2006, is read by experienced nurses, midwives, health visitors and advanced nursing students in over 80 countries. It informs, educates, explores, debates and challenges the foundations of nursing health care knowledge and practice worldwide.

Edited by Professor Alison Tierney, it is published 24 times a year by Blackwell Publishing Ltd, part of the international Blackwell Publishing group.

http://www.journalofadvancednursing.com

Menthol Discovery Could Point Towards New Or Improved Pain Therapies

This new understanding could lead to potential advances in pain therapy, the researchers said. Moreover, the scientists envision that their method may be potentially useful in studying the activation mechanism of other drugs and proteins.

"Because our ability to sense temperature is closely linked to our ability to sense pain, it is not surprising that the misregulation of temperature-activated ion channels can result in chronic pain syndromes," said Ardem Patapoutian, associate professor at Scripps Research and member of GNF, who directed the research. "In fact, some of these ion channels are considered targets to treat chronic inflammatory and neuropathic pain indications. Understanding how small molecules such as menthol affect the function of these proteins could be crucial in designing future drugs that can either activate or block them."

The study was released in an advanced online version by the journal Nature Neuroscience. It will be published in the journal's April edition (Vol. 9, No. 4).

Utilizing a novel mutagenesis and high-throughput screening approach, the study assayed 14,000 TRPM8 mutants to find mutants that were not enhanced by menthol but were otherwise functioning normally. The scientists' analysis pinpointed a potential interaction site for menthol, as well as a site that translates binding information to ion channel activity.

Ion channels are proteins found in the cell membrane that can form a tunnel or channel that allows specific ions to move across the membrane. When activated, the channel opens, allowing an influx of calcium ions into the axon, an electrical signal that alerts the neuron, which relays the message to the brain.

Research Associate Michael Bandell, the lead author of the study, noted, "It's a well established method to mutate individual amino acid residues in an ion channel protein and examine the effect that these mutations have on the channel's function. However, the laborious nature of these experiments limits the number of mutant ion channels that can be made and analyzed. Our new high-throughput screening methodology allowed us to analyze 14,000 mutants out of which we isolated five that specifically affected menthol activity. Our experiments yielded significant insights into the functional elements of TRPM8 ion channel protein that would have been difficult to obtain using other mutagenesis methods."

Because the methodology can be used to screen for activation or inhibition, Bandell added, it could prove to be useful as a general method to analyze the mechanism by which drugs can activate or inhibit ion channels or other receptors. Specifically, the new methodology could be used to identify amino acid residues in certain ion channel proteins and G-protein coupled receptors (proteins involved in stimulus-response pathways) that are involved in the interaction with small molecules that affect their function.

###

Other authors of the study include Adrienne E. Dubin of Scripps Research, Matt J. Petrus of GNF, Anthony Orth of GNF, Jayanti Mathur of GNF, and Sun Wook Hwang of Scripps Research.

The study was supported by the National Institute of Neurological Disorders and Stroke, the Novartis Research Foundation, the American Heart Association, and the Damon Runyon Cancer Research Foundation.

About The Scripps Research Institute
The Scripps Research Institute, headquartered in La Jolla, California, in 18 buildings on 40 acres overlooking the Pacific Ocean, is one of the world's largest independent, non-profit biomedical research organizations. It stands at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its research into immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel.

Scripps Florida, a 364,000 square-foot, state-of-the-art biomedical research facility, will be built in Palm Beach County. The facility will focus on basic biomedical science, drug discovery, and technology development. Palm Beach County and the State of Florida have provided start-up economic packages for development, building, staffing, and equipping the campus. Scripps Florida now operates with approximately 160 scientists, technicians, and administrative staff at 40,000 square-foot lab facilities on the Florida Atlantic University campus in Jupiter.

Contact: Keith McKeown
kmckeown@scripps.edu
Scripps Research Institute

National Nutrition Month Tips From VA

March is National Nutrition Month. Eating well can help reduce the risk of chronic diseases like cancer, diabetes, obesity, and hypertension. Eating well means eating a variety of healthy foods in the right amounts so your body gets the nutrients needed to maintain good health and work properly.

What exactly are the nutrients that come from food? Different foods provide different kinds of nutrients:

-- Proteins (lean meats, eggs, beans, nuts) help build muscle and a strong immune system.

-- Carbohydrates (starches, sugar and whole grains that also provide fiber) give you energy.

-- Fats provide essential fatty acids and extra energy.

-- Vitamins and minerals (commonly available in fruits, vegetables and whole grains) regulate body processes, enhance cell function and growth and help build a strong immune system.

-- Water gives cells shape and acts as a medium where body processes can occur.

Including a variety of fruits, vegetables, whole grains, and lean proteins into each meal will help ensure that your body gets the right amount of the essential nutrients. Eating too many saturated fats and sugars can lead to excess weight gain and chronic disease. A recent study from the San Francisco VA Medical Center showed that Omega 6 fatty acid can promote prostate tumor cell growth in human prostrate cancer tissue cultures.1 Corn oil is a major source of omega 6 fatty acids, used extensively in the United States' food processing, frying and baked goods. A healthy balance for your fat intake should include higher daily intakes of monounsaturated fats (olive, canola and peanut oils) along with omega 3 fatty acids, which one can get by consuming fish at least twice a week. Avoid trans-fatty acids found in many processed foods.

In general, processed foods tend to lose many of their vitamins during the manufacturing process and often have other less healthy ingredients added such as corn syrup and trans fats. Thus, the term empty calories is often used to describe foods like soda and potato chips. Replacing processed foods in your diet with more fresh foods like fruits, vegetables and plain water helps promote a healthy diet. Additionally, a St. Louis VA Medical Center study in 2004 found that reducing the amount of fat and empty calories in your diet may help improve memory2.

The following are tips on how to practice good nutrition this month and every month:

-- Eat smaller meals including a vegetable as the center of the plate, with smaller meat and starch servings. Include at least one serving of fruit and vegetable with every meal.

-- Drink more water between meals; try veggies or a handful of nuts for a snack and fresh fruit for something sweet.

-- Reduce your intake of deep fried foods and cancer-causing trans fats found in processed foods and baked goods.

-- Read food labels and reduce the amount of added sugar, corn syrup and salt in the diet. Use fresh herbs and spices to season food instead.

VA offers veterans an online tool to help them track their food intake and manage their nutrition. The MyHealtheVet Web site has an online food journal to help veterans monitor what they eat. It also offers tips and information on health and wellness. Veterans (as well as their families and advocates) can log on to www.myhealth.va.gov and begin tracking their food intake today. The journal may be used as a tool for follow-up nutrition counseling with a local registered dietitian. VA provides nutrition counseling as a health care benefit to enrolled veterans. For more information on nutrition, veterans may contact their local VA Medical Center.

Additionally, the VA offers an Internet reference site for reliable links to nutrition resources at http://www.va.gov/nfs/veternnutrition.htm

Veterans Affairs (VA) R&D
103 S. Gay St., Ste 517
Baltimore, MD 21202
United States
http://www.va.gov/resdev

Pregnancy Diet Has Lifelong Effects For Baby

University of Nottingham researchers are targeting Europe's biggest killer diseases - by focusing on the diet of unborn babies.

Poor nutrition in the womb and in the first months of infancy can condemn an individual to a life of poor health including higher risks of obesity, diabetes and cardiovascular disease.

Scientists believe a baby is ‘programmed' for a lifetime of good or poor health in its first few months by the type and amount of nutrition they receive.

Experts at The University of Nottingham are now heading up part of an £11m project to pinpoint the best way of giving babies a healthy start that will benefit them for the whole of their lives.

Their findings will help to shape public policy on mothers' diet in pregnancy and lactation. The Nottingham team believes the project could have as big an impact on public health as other lifestyle interventions - such as decreasing food intake and increasing exercise - which are much more difficult to impose.

Professor Michael Symonds, Head of the Academic Division of Child Health at Nottingham University Medical School, said: “What your mother eats and how you are fed as a baby can programme you for a lifetime of good health or bad health.

“This obviously has important health implications worldwide, given that we are living longer, more people are getting cardiovascular disease and we need to get to grips with the mechanisms behind this.”

The EU-funded project is known as EARNEST, its full title being ‘Early Nutrition Programming - Long-term follow-up of efficacy and safety trials and integrated epidemiological, genetic, animal, consumer and economic research'.

The University of Nottingham team is embarking on a series of intervention studies, manipulating diet during pregnancy and lactation to establish the optimum dietary patterns for humans.

Professor Symonds said: “There are two types of baby we should be particularly concerned about - both the baby that is too small and the baby that is too large. There has been a 20 per cent increase in birth weight over the last 10-15 years.

“That is, in part, due to the fact that mothers are larger when they are getting pregnant and are more likely to suffer from pregnancy diabetes, that is they are unable to control their blood glucose adequately.

“The result of that is the baby will actually be larger at birth… which could well be one factor that is contributing to later obesity. If you start off being too large at birth, then you are on a track to remain too large through later life.

“At the same time, a baby of normal size at birth, but who is given too much formula milk, which the mother will perceive as a good thing - i.e. that the baby is growing fast - in clinical terms it may potentially be growing too fast.

“That baby may be at more risk of later disease because when you grow too rapidly one of the adaptations is you lay down too much fat. Once you have too much fat in early life that can stay with you throughout your life: you may become obese earlier with all the complications that go with that.”

EARNEST is a Europe-wide project bringing together scientists from 38 research institutions across 16 countries in the fields of genetics, molecular biology, epidemiology, public health and consumer behaviour.

Professor Berthold Koletzko, of the University of Munich, is co-ordinating the six research initiatives that make up the EARNEST project.

Professor Koletzko said: “Major differences in risk factors for significant health problems - such as cardiovascular disease, diabetes, obesity, bone health, immune function, cognitive development and behaviour - have already been observed in children who experienced different diets in the first few months of life, or whose mothers were given different supplements during pregnancy.

“These studies have not been running long enough to know whether the differences seen in childhood persist into adult life. If they do, the impact on the health of future generations is enormous.”

UNIVERSITY OF NOTTINGHAM
University Park
Nottingham
NG7 2RD
http://www.nottingham.ac.uk

Obese People Are More Sensitive To Pain, Suggests Study

COLUMBUS , Ohio

Obese people may be more sensitive to pain than people who aren't obese, a new study suggests.

All of the older adults who completed the study had osteoarthritis of the knee, a disease that causes inflammation and extreme pain in the knees.

Participants were given a mild electrical stimulation on their left ankle to measure their pain reflex. The stimulus was given before and after the participants took part in a 45-minute coping skills training session that included a progressive muscle relaxation exercise.

The obese patients showed a greater physical response to the electrical stimulation than did the non-obese people, both before and after the training session. This indicates they had a lower tolerance for the painful stimulation despite reporting, in questionnaires, that they felt no more pain than non-obese people.

"The relaxation procedure helped both groups cope with pain," said Charles Emery, the study's lead author and a professor of psychology at Ohio State University. "Additionally, our tests showed both groups had higher physical pain thresholds after the relaxation session. But the obese participants still had a lower threshold for tolerating the pain."

"This is important because if an obese person begins an exercise program, he may not cognitively experience pain when in fact it is hurting the body on some level," Emery said. "That could lead to severe pain down the road."

Emery and his colleagues presented their findings on March 4 in Denver at the annual meeting of the American Psychosomatic Society.

The researchers wanted to see if coping skills training, including progressive relaxation techniques would help people with osteoarthritis to better cope with the pain that the disease can cause. Also called degenerative joint disease, osteoarthritis affects more than 20 million people in the United States.

But they were particularly interested in seeing how the obese group responded to pain; according to Emery, a small number of studies have looked at pain sensitivity in obese people, but many of these studies report conflicting results.

"Some studies say that obese people are more tolerant of pain, while other studies say they are less tolerant," Emery said.

About a third of the study's 62 participants were obese. Researchers determined who was obese based on participants' body mass index (BMI) scores, which relates height to weight. Obese patients in this study had a BMI greater than 30 but less than 35. (Scores higher than 35 are considered morbidly obese.)

The participants underwent two rounds of electrical stimulation – once before, and once after a 45-minute training session where they learned different ways of coping with pain, including instruction in progressive muscle relaxation therapy.

The electrical stimulation came from an iPod-sized device that delivered a slight electrical shock to a patient's sural nerve, a nerve that extends along the ankle and into the calf. This kind of electrical stimulation causes sensations of tingling and mild pain in the lower leg.

The researchers determined the body's response to sural nerve stimulation by measuring the reflex of the lower leg muscles that surround the sural nerve. When the brain senses pain, it sends a message to the body to contract and move the muscles in order to get away from the source of the pain.

"This kind of evaluation is in some ways a more objective way of measuring the body's response to pain, as opposed to simply asking someone if they feel pain," Emery said.

But the researchers did ask participants how much pain they felt. Participants completed questionnaires about anxiety and pain perception after each round of electrical stimulations. All participants, obese or not, reported that they felt less pain after the relaxation session than they did before.

Yet results of the sural nerve stimulus test showed that the obese participants did not tolerate the painful stimulus as well as the non-obese individuals.

"Our findings show the importance of looking at objective as well as subjective measurements of how the body responds to pain stimuli," Emery said.

Emery conducted the study with colleagues from Ohio State, Ohio and Duke universities.

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Contact: Charles Emery, (614) 688-3061; emery@psy.ohio-state.edu

Written by Holly Wagner, (614) 292-8310; Wagner.235@osu.edu

Contact: Charles Emery
emery@psy.ohio-state.edu
Ohio State University

Avian Influenza And Food Safety

Since the beginning of February 2006, the highly pathogenic H5N1 avian influenza virus has spread to affect wild or domestic birds in 17 new countries in Africa, Asia, Europe, and the Middle East.

The World Health Organization reconfirms that, when poultry products are safely handled and properly cooked, humans are not at risk of acquiring H5N1 infection through food.

Although the H5N1 virus is highly infectious among poultry, it is not easily transmissible to humans. Since December 2003, this virus is known to have infected 173 people, of whom 93 have died. Not one of these cases has been linked to the consumption of properly cooked poultry or poultry products.

The main health risk currently is to people who are in close contact with infected poultry, such as families with backyard flocks and poultry workers in wet markets or live animal markets.

Heightened surveillance among domestic and wild birds, rapid detection of the virus, and swift implementation of control measures are important in supporting and maintaining consumer confidence in the safety of poultry products.

Globally, the evidence demonstrates that there is no risk of infection when birds and eggs are well-cooked, as this kills the virus. Poultry products are important sources of protein throughout the world.

www.who.int

New Treatment For Back Pain

From the 1 of March the Osteopathy and Manual Medicine Service at the Policlínica San José in Vitoria-Gasteiz, administrative capital of the Basque Autonomous Community, will have the very first Vertebral Axial Decompression Table in Spain. Patented by the North American firm, Vax-D, this will be the third Table in Europe (they have just acquired two more in Great Britain).

The new table enables the treatment of problems of the spinal column, in the lumbar region, where there is acute and/or chronic pain caused by disc hernias, degeneration of the discs, posterior facet syndrome, discoarthrosis and sciaticas.

The treatment uses an exclusive system for the decompression of the intervertebral discs and the vertebral articulations, thus enabling the introduction of the herniated disc apart from separating the vertebrae to improve their functioning and to produce a stretching of the contacted muscles.

This system for vertebral decompression is what differentiates this treatment from any other system used for complaints of this kind.

The treatment has been successfully carried out in the USA for more than ten years and the equipment to arrive in Vitoria-Gasteiz in March will be the first in Spain. The technique has an efficacy rate of about 80%, depending on the pathology.

Over the last few years, Dr. J.C. Vicente, Director of the Osteopathy and Manual Medicine Service, has undertaken a thorough-going monitoring of the operation of the Vax-D in the USA, sending patients to be treated there with this method and, thus, confirming its efficacy and positive results. The experience was the motive for bringing the treatment technique to Vitoria-Gasteiz. It will be, in many cases, an alternative to surgery, thus reducing the risks inherent in the operation theatre as well as cutting the recovery time for patients with these complaints.

The treatment is painless and involves daily sessions of 30 minutes over a period of 20 days.

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Contact: Irati Kortabitarte
iratik@elhuyar.com
Elhuyar Fundazioa